The health of the gut microbiome has pulled increasing focus as a driving factor of disease development in IBS, resulting in a slew of research on probiotics and prebiotics as potential treatments.
Here’s where the research currently stands, and how to best use probiotics and prebiotics for IBS symptom management.
What are Probiotics?
Probiotics are a mixture of live microorganisms that support the trillions of bacteria in the body and help maintain “good” bacteria. Probiotics can be highly beneficial to gut function and immune health, which depend on a thriving microbial community and balance between good and pathogenic bacteria.
Probiotics can also be taken as supplements, but are also found naturally in many fermented foods such as yogurt, miso, and kimchi.
Are Probiotics Good for IBS?
The NHS recommends trying probiotics for a month to see if they help. This is because IBS is believed to be a disorder of the gut-brain axis. The gut-brain axis is a term to describe the bidirectional communication and signaling between the gut, gut bacteria, and the enteric and central nervous systems.
An impairment of this communication can trigger IBS symptoms, which means that probiotics may benefit IBS patients by supporting the health and balance of our gut bacteria, thereby improving digestive symptoms.
Best Probiotics for IBS
A challenge in the study of probiotics for certain conditions lies in the fact that different strains of bacteria within the probiotic will have very different effects on the body. Their influence may also alter depending on different populations, stages, and types of disease. And then, of course, everyone’s microbiome is somewhat unique, so there may be a process of trial and error in finding the right probiotic for you.
As IBS has a wide range of symptoms, it’s best to seek a strain of probiotics shown in clinical trials to benefit your specific symptoms. There are also ‘all-rounder’ probiotics that may boost your general gut health if not target specific symptoms.
Of the many probiotic strains, Lactobacillus and Bifidobacterium have shown the most benefits for IBS, especially when taken together with prebiotics.
Lactobacillus acidophilus NCFM® was shown to help with bloating and abdominal cramps (Faber, SM. 2000). Researchers found this strain was able to induce the expression of μ-opioid and cannabinoid receptors in intestinal epithelial cells, exerting pain-relieving effects in the abdomen.
In a recent study on 330 participants with IBS, Lactobacillus acidophilus DDS-1 not only improved symptom severity and quality of life but alleviated perceived stress levels. Lactobacillus plantarum 299v has also shown similar improvements for IBS patients, with a significant reduction of abdominal pain, flatulence, diarrhea, and constipation. This may be the best strain for IBS-C patients.
Bifidobacterium bifidum MIMBb75 was also found in trials to relieve IBS symptoms, with significant improvement in pain, discomfort, bloating, urgency, and overall quality of life. In a large-scale study that included only women with IBS, a higher dose of Bifidobacterium infantis 35624 was found effective for abdominal pain, bowel dysfunction, incomplete evacuation, straining, and gas compared to a placebo.
It’s important to understand that everyone’s microbial environment is a little different, so a probiotic strain may have a varied effect on different people. It may help to see a registered dietitian who can offer guidance in finding the right probiotic for you.
What are Prebiotics?
Prebiotics are high-fiber foods or fermentable carbohydrates that can’t be broken down by the digestive system. Instead, they bypass the digestive process and wind up in the colon to feed the probiotic bacteria and help them flourish.
Prebiotics can be taken as supplements, or found in a wide range of foods including apples, barley, berries, cocoa, garlic, oats, and legumes.
Are Prebiotics Good for IBS?
Prebiotics may be generally beneficial for IBS patients, as they nourish and support the growth of Bifidobacteria and Lactobacilli, which are found in lower levels in IBS patients. Prebiotic foods can lower inflammation, and promote the production of short-chain fatty acids and vitamins to further improve digestive health and the intestinal immune system.
As prebiotics also nourish probiotics, many take the two together in a combination called synbiotics. Synbiotics can be found in supplements or by combining pre and probiotic foods.
While there is sparse evidence of prebiotics alone improving GI symptoms, a 2019 study tested synbiotics on IBS patients and saw a significant improvement in GI symptoms and fatigue in the high-dose group.
Best Synbiotics for IBS
A synbiotic called Lactol® containing Bacillus Coagulans has been found to reduce the frequency of abdominal pain and diarrhea in IBS patients.
Another synbiotic called Ultra-Probiotics-500, which included several strains of Lactobacillus and Bifidobacterium and inulin powder (a prebiotic fiber) was found to improve bloating, fatigue, and abdominal discomfort in IBS patients.
How to Incorporate Probiotics & Prebiotics into Your Diet
Integrating probiotics and prebiotics into your daily diet is one of the best ways to maintain a healthy, balanced, and thriving microbial community. A good starting point is combining prebiotic and probiotic foods into your meals, or adding prebiotic foods to your probiotic supplements.
Please note that when adjusting your diet with IBS or any digestive disorder, it’s important to consult with a registered dietician or healthcare professional so they can tailor a dietary plan that works for your constitution, condition, and personal needs.
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